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Abstract #46809 Published in IGR 13-3
The effect of learning curve on the surgical outcome of viscocanalostomy
Stangos AN; Mavropoulos A; Leuenberger PM; Sunaric-Megevand GJournal of Glaucoma 2011;
PURPOSE: To evaluate the influence of learning curve on the surgical outcome of viscocanalostomy. METHODS: Retrospective, interventional study. Chart review of the first consecutive open-angle glaucoma cases that received viscocanalostomy in 1 institution between July 1996 and June 2000. Overall success was defined as no visual field deterioration; postoperative intraocular pressure (IOP) (less-than or equal to)20 mm Hg; and IOP reduction (greater-than or equal to)30% compared with baseline values with or without medication. When medications were not required, success was defined as complete. Demographic, procedural, and postoperative data were tabulated and analyzed. Primary outcome measures: overall and complete success rates. Secondary outcome measures: number of glaucoma medications and surgical complications. RESULTS: A total of 180 cases were analyzed. Mean follow-up ((plus or minus)SD) was 28.9(plus or minus)5.9 months (range, 12-36 mo). Overall success has significantly improved from 64% to 91% when comparing the first 45 to the last 45 cases of the series (Mantel-Cox, P=0.005). Similarly, complete success has significantly improved from 38% to 73% (Mantel-Cox, P=0.004). The mean number of glaucoma medication ((plus or minus)SD) significantly decreased from 2.58(plus or minus)0.94 before surgery to 0.53(plus or minus)0.79 after surgery (Wilcoxon, P<0.001). Surgical complications decreased from 16 in the first 45 cases to 10 in the last 45 cases without reaching statistical significance (Pearson (chi), P=0.315). CONCLUSIONS: Viscocanalostomy appears to safely reduce IOP in cases with medically uncontrolled open-angle glaucoma. Mastering viscocanalostomy procedure is achievable after the first 40 cases.
A. N. Stangos.
Classification:
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
